Provider Demographics
NPI:1356321210
Name:HOWELL, MALCOLM (MD)
Entity Type:Individual
Prefix:DR
First Name:MALCOLM
Middle Name:
Last Name:HOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 ST FRANCIS BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3222
Mailing Address - Country:US
Mailing Address - Phone:804-320-2483
Mailing Address - Fax:804-419-1860
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-320-2483
Practice Address - Fax:804-419-1860
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041590207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
11939OtherCARENET
226118OtherANTHEM
VAC09633OtherGROUP PTAN
18963OtherOPTIMA HEALTH
0000102403801OtherUNITED
160049263OtherRR MEDICARE
6201067OtherVA PREMIER
1460032OtherCIGNA
VA006201067Medicaid
18963OtherSENTARA
94531OtherSOUTHERN HEALTH
2000796OtherAETNA USHEALTH
328077OtherMAMSI
541941044002OtherTRICARE
541941044002OtherTRICARE
D40192Medicare UPIN